Dealing with Premature Menopause

Read one woman's journey through early menopause

Several years ago, over a late-night dinner with a close friend, I admitted to a secret worry, "I'm pretty sure," I muttered, "that I've started menopause."

"Ridiculous!" she snorted. "You're far too young. You're not having symptoms like"—here she leaned in and whispered into her cupped hand—"vaginal dryness, are you?"

I got virtually the same reaction from another friend. A widow nearly 10 years older than I, she gasped when I told her. "You can't be serious," she said. "You're only 39, beautiful, and you hardly even have any wrinkles…"

Most Popular

Too young. My friends were both right and wrong. Most women don't reach menopause until about 51. For 1% to 4% of women under 40, however, "the change" comes early, and—just my luck—I'm now a member of the club.

Pimples and Wrinkles?!

In my mid-30s, I began to have abnormally heavy periods. I didn't think much of it at first—I'd just given birth to my third child— but then I also started to break out. I really didn't mind a few pimples; if anything, they seemed like proof of my youth. But I was also beginning to notice a few lines on my forehead and around the corners of my mouth.

There were other changes, too. Previously a sound sleeper, I now tossed and turned all night long. Most of the time I felt frazzled, angry or depressed. Prone to being so chilly that I sometimes wore cashmere sweaters in the middle of August, now I was always hot, especially at night. Understandably, my husband began staying on his side of our bed. Our sex life seemed to wither with the heat.

My periods became erratic—months could pass without one, or one would arrive and last for a month. Then, just after my 40th birthday, they suddenly stopped altogether. With huge reluctance, I had no choice but to recognize the symptoms.

For months I strove to take them in stride. The three times I'd given birth, I'd sprinted out of the hospital within hours; I wasn't going to let this throw me. I'd had my children and we weren't planning to have any more. So no big deal, right?

Wrong. Why did I feel like screaming whenever I saw a book with a cheesy title like Embracing Menopause? Why was I spending precious minutes each morning searching my reflection in the mirror for age spots or a sagging jawline? It was as if, instead of looking at myself, I was looking for myself. The self that I used to be. For months I plodded through my days with a lump in my throat, close to tears.

Advertisement - Continue Reading Below

A New Curse?

I remember a public health campaign, back when I was in my teens, that cheerily advised women to view their monthly cycle as a celebration of womanhood, not as "the curse." My mother, sister and I thought that was beyond funny and started announcing to each other when we were "celebrating." Now that I lacked a monthly "celebration," it felt like a new curse. I worried that I had turned a corner, headed down a road leading to the end of youth, of life itself.

Meanwhile, my husband complained that I was increasingly testy; this from a man who has long claimed that my fiery temperament is one of the things he likes most. If he was complaining, things must be bad. Though he assured me of his love—and wasn't pushing for any more kids—he admitted that he was a bit disappointed that I was no longer able to get pregnant. In his male brain, he said, the very notion that he might make me pregnant was an ingredient in his lust.

I finally reported to my ob-gyn. All my symptoms, she said, were consistent with the decreasing estrogen level associated with—out came the standard euphemism—"the change of life." A blood test confirmed that, at 40, I was indeed going through it. "Why me?" I asked. She admitted that she didn't really know.

It can be difficult, I've since discovered, to pinpoint the cause of early menopause. If a woman is under 40, it's called premature menopause; for those between 40 and 45, it's referred to as early-onset menopause. Sometimes premature menopause is brought on by surgery, chemotherapy, hypothyroidism or an autoimmune disorder like lupus. For other women, like me, doctors can say only that our ovaries have stopped working before 40 for no apparent reason. Sometimes this is referred to as premature ovarian failure (POF).

Hormonal Havoc

Normally, the transition to menopause starts in the early 40s, when hormone levels begin to vary dramatically and estrogen levels gradually decline. Known as perimenopause, this window lasts until about a year after your last period, during which you can have irregular periods, hot flashes, mood swings and, oh yeah, loss of interest in sex. After you've had no period for one year, you're considered to have officially reached menopause.

The obvious loss of fertility aside, premature menopause can have other serious health consequences. Because you wind up spending more of your life without the protective benefits of estrogen, you're also unfortunately at greater risk for problems like osteoporosis, cataracts, gum disease, and even colon and ovarian cancer.

To reduce my now-elevated risk of these conditions—and keep me as comfortable as possible—my doctor suggested that I take hormone therapy (HT). I was surprised because I'd heard about studies that linked HT to breast cancer and heart disease. What I didn't know was that this research focused on women of normal menopausal age, and that HT appears to be much safer for those of us who hit menopause years earlier. That's because the hormones would be replacing those that my body should still have been making naturally at my age.

My doctor assured me that the benefits of HT for me far outweighed any risks, but I sought a second opinion anyway. After getting the extra reassurance I needed, I filled the prescription. (When I reach 51—normal menopausal age—my doctor will reassess and help me decide whether to stay on the hormones or discontinue them at that point.)

Finding Myself Again

Within a week of starting HT, all my miserable symptoms—the hot flashes, the sleeplessness—vanished. I had a few weeks of bloating and weight gain, but that soon disappeared. I've also turned the corner on the depression that has dogged me for the last few years.

This whole experience has been like the significant gap you often find in a great piece of classical music. The pianist's tinkling comes to a stop and the audience waits until, with a crash and a flourish, the exciting final movement begins. For me, menopause has truly proven to be a "pause," not an end.

A few months after I started taking HT, my husband decided I had cooled down enough to turn the heat back up in another sort of way. He took me (equipped with a fetching black corset) off to Venice for a long weekend. There, as we lay in our big bed, we got a text message from a dear friend whose wife of many years had just passed away. "You're lucky to have each other," it read. "Remember that." Suddenly, the lump in my throat was back again—but this time it was because of what I still had, rather than what I had lost.